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NBCOT- Psychiatric and Cognitive Disorders
MH
130
Medical
Graduate
02/06/2013

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Term
Disorientation
Definition
A disturbance of orientation to person, place, or time
Term
Delirium
Definition
A disoriented reaction with restlessness and confusion
Term
Confusion
Definition
Inappropriate reactions to environmental stumuli
Term
Sundowning
Definition
Occurs in the late afternoon/evening, characterized by drowsiness, confusion, ataxia, falling, agitation
Term
Distractability
Definition
the inability to concentrate one's attention without attention being drawn to unimportant stimuli
Term
Selective Inattention
Definition
Blocking out activities, objects, or concepts that produce anxiety
Term
Hypervigilance
Definition
Excessive attention and alertness that guards against potential danger
Term
Trance
Definition
A sleep-like state with minimal environmental awareness followed by amnesia for the experience
Term
Blunted Affect
Definition
Severe lack of affect
Term
Echopraxia
Definition
Meaningless imitation of another person's movements
Term
Catatonia
Definition
Characterized by immobility or rigidity
Term
Stereotypy
Definition
Repeated fixed patterns of movement and speech
Term
Psychomotor Agitation
Definition
Excessive motor and cognitive activity
Term
Akathisia
Definition
State of restlessness characterized by a urgent need for movement
Term
Ataxia
Definition
The irregularity or failure of muscle coordination upon movement
Term
Circumstanstiality
Definition
Speech that is delayed in reaching the point and contains excessive or irrelevant details
Term
Tangentiality
Definition
Abrupt changing of focus to a loosely associated topic
Term
Perseveration
Definition
A persistent focus on a precious topic or behavior after a new topic or behavior has been introduced
Term
Flight of Ideas
Definition
Rapid shifts in thoughts from one idea to another
Term
Thought Blocking
Definition
The interruption of a thought process before it is carried through to completion
Term
Delusions
Definition
False beliefs about external reality without an appropriate stimulus that cannot be explained by the individual's intelligence or cultural background
Term
Compulsions
Definition
A need to act on a specific impulse to relieve associated anxiety
Term
Obsessions
Definition
A persistent thought or feeling that cannot be eliminated by logical thought
Term
Poverty of Speech
Definition
Speech that is limited in amount and content
Term
Expressive Aphasia (Broca's)
Definition
A disturbance in which the individual knows what they want to say but cannot say it
Term
Receptive Aphasia (Wernicke's)
Definition
An organic loss of the ability to comprehend what has been said
Term
Nominal Aphasia
Definition
Inability to name obects
Term
Global Aphasia
Definition
Involves all forms of aphasia
Term
Hallucinations
Definition
False sensory perceptions that are not in response to an external stimulus
Term
Illusions
Definition
Misperceptions or misinterpretations or real sensory events
Term
Agnosia
Definition
Inability to understand and interpret the significance of sensory input
Term
Astereognosis
Definition
Inability to identify objects through touch
Term
Visual Agnosia
Definition
Inability to recognize people and objeects
Term
Apraxia
Definition
Inability to carry out specific motor tasks in the absence of sensory/motor impairment
Term
Adiadochokinesia
Definition
Inability to perform rapidly alternating movements
Term
Depersonalization
Definition
A subjective sense of being unreal or inanimate
Term
Derealization
Definition
A subjective sense that the environment is unreal
Term
Fugue
Definition
A state of serious depersonlization, often involving travel or relocation, in which the individual takes on a new identity with amnesia for their old identity
Term
Dissociative Identity Disorder
Definition
Involves the appearance that the individual has developed two or more distinct personalities
Term
Amnesia
Definition
The inability to recall past experiences or personal identity
Term
Retrograde amnesia
Definition
The inability to remember events that occurred prior to the precipitating event
Term
Clinical observations to make when evaluating a client with a psychiatric disorder
Definition
1. Appearance
2. Speech
3. Actions
4.Thoughts
Term
Shortened forms of the mental status examination
Definition
1. The Folstein Mini-Mental
2. The Short Portable Mental
Term
DSM- Axis I
Definition
Identifies the the clinical disorders and other conditions that may be a focus of clinical attention
Term
DSM- Axis II
Definition
Includes personality disorders and intellectual disability
Term
DSM- Axis III
Definition
Includes general medical conditions
Term
DSM- Axis IV
Definition
Lists psychosocial and environmental problems
Term
DSM- Axis V
Definition
Provides a global assessment of functioning (GAF)
Term
Diagnostic Criteria for Schizophrenia
Definition
Two or more of the following symptoms:
1. Delusions
2. Hallucinations
3.Disorganized speech
4.Grossly disorganized or catatonic behavior
5. Negative Symptoms
Term
Schizophrenia- Paranoid Type
Definition
-Characterized by preoccupation with one or more delusions or persecution or grandeur
-Auditory hallucinations are frequently present
-Tend to exhibit fewer negative symptoms
Term
Schizophrenia- Disorganized Type
Definition
Characterized by marked regression demonstrating primitive, disinhibited, and disorganized behavior
Term
Schizophrenia- Catatonic Type
Definition
Characterized by severe disturbances in motor behavior involving stupor, negativism, rigidity, excitement, or posturing
Term
Schizophrenia- Undifferentiated Type
Definition
Used to classify those patients who do not clearly fit into the other categories of schizophrenia
Term
Schizophrenia- Residual Type
Definition
USed when there is continued evidence of schizophrenic behavior in the absence of a complete set of diagnostic criteria
Term
Schizophreniform Disorder
Definition
Meets the criteria for schizophrenia; however, the episode lasts more than one month but less than the six months required for the diagnosis of schizophrenia
Term
Schizoaffective Disorder
Definition
The person has an uninterrupted period of illness during which, there is a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet criterion A for schizophrenia
Term
Delusional Disorder
Definition
The individual's predominant symptoms are non-bizarre delusions with the absence of other criterion A symptoms of schizophrenia
Term
Brief Psychotic Disorder
Definition
Person experiences at least one day but less than one month with one or more criterion A symptoms of schizophrenia which result from severe psychosocial stress
Term
Medical Management of Schizophrenia
Definition
Antipsychotics: Ex, Thorazine, Proloxin
Term
Side Effects of Antipsychotics
Definition
Dry mouth, photosensitivity, orthostatic hypotension, tardive diskinesia
Term
Neuroleptic Malignant Syndrome
Definition
Severe Complication of Antipsychotic Meds ** Emergency
Increased blood pressure, tachycardia, sweating, convulsions, and coma
Term
When working with people with psychotic disorders...
Definition
-Therapist must communicate simply, clearly, and concretely
-Provide external structure to organize the individual's thinking, environment, and daily activities
Term
Major Depressive Disorder
Definition
One or more depressive episodes
Term
Bipolar I Disorder
Definition
-One or more manic episodes
-May be combined with depressive episodes
Term
Bipolar II Disorder
Definition
-One or more major depressive episodes
-There must be at least one hypomanic episode
Term
Dysthymia
Definition
At least 2 years of a depressed mood, symptoms not severe enough to meet the criteria for major depressive disorder
Term
Cyclothymic Disorder
Definition
At least 2 years with numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a manic episode or a major depressive episode
Term
Manic Episode
Definition
A distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week
Term
Behaviors associated with a manic episode
Definition
1. Treatment-resistance from failure to recognize illness
2. Suggestive or flamboyant dress
3. Gambling, promiscuity, excessive spending, or giving things away
4. Irritable, assaultive, or suicidal behavior
Term
OT Treatment for Manic Episodes
Definition
-Limit setting
-Engagement in activities that provide for release of excess energy
Term
Major Depressive Episode
Definition
A two week period of depressed mood or loss of interest and pleasure
Term
Medical Management of Depression
Definition
-SSRI's
-SNRI's
-Tricyclics
-MAOI's
Term
MAOI Dietary Restrictions
Definition
Items that contain the amino acid Tyramine: aged cheese, pickled foods, smoked meats, yogurt, sour cream, ripe fruits, chocolate, beer, soy
Also- cold medicines, nasal decongestants, asthma inhalers
Term
Hypomanic Episode
Definition
Symptoms the same as a manic episode; not as severe
Term
Two Categories of Substance-Related Disorders
Definition
1. Dependence
2. Abuse
Term
OT Treatment of Substance-Related Disorders
Definition
-IDing reasons for substance use
-Development of skills necessary to cope with life stressors without substance
-Communication and social skills to support substance-free social participation
-Skills to engage in work or education
-Skills to participate in leisure
-Referral to support groups
Term
OT Treatment of Anxiety Disorders
Definition
-Skill training using cognitive behavioral approach
-Relaxation and stress management
-Providing graded activities to promote self-efficacy to increase confidence, motivation, and participation in intervention
Term
Personality Disorder Groupings: Cluster A
Definition
Paranoid, schizoid, schizotypal
-odd, eccentric
Term
Personality Disorder Groupings: Cluster B
Definition
Antisocial, borderline, histrionic, narcissistic
-dramatic, emotional, erratic
Term
Personality Disorder Groupings: Cluster C
Definition
Avoidant, dependent, obsessive-compulsive
-anxious, fearful
Term
Paranoid Personality Disorder
Definition
-Longstanding suspiciousness and mistrust of people
-Refuse responsibility for their own feelings
-Can appear hostile, irritable, angry
Term
Schizoid Personality Disorder
Definition
Lifelong pattern of social withdrawal
-eccentric, isolated, lonely
Term
Schizotypal Personality Disorder
Definition
Appear odd/strange int heir thinking and behavior
-magical thinking, peculiar ideas, illusions
Term
Antisocial Personality Disorder
Definition
Continual antisocial or criminal acts
-inability to conform to social norms
-No regard for the safety or feelings of others and they lack remorse
Term
Borderline Personality Disorder
Definition
Extraordinarily unstable affect, mood, behavior, relationships, and self-image
-fear of real or imagined abandonment
-most have a history of trauma
Term
Histrionic Personality Disorder
Definition
Colorful, dramatic, extroverted behavior in excitable, emotional persons
-Inability to maintain deep, lasting relationships
Term
Narcissistic Personality Disorder
Definition
Heightened sense of self-importance and grandiose feeling that they are special in some way
Term
Avoidant Personality Disorder
Definition
Extreme sensitivity to rejection which may lead to a socially withdrawn life
-these individuals are not asocial
-great desire for companionship, feel inept or unworthy
Term
Dependent Personality Disorder
Definition
Subordinate their own needs to those of others and need others to assume responsibility for major areas in their lives
-lack self-confidence
-discomfort with being alone
Term
Obsessive-Compulsive Personality Disorder
Definition
Emotional constriction, orderliness, perseverance, stubbornness, indecisiveness
-Essential feature: pervasive patterns of perfectionism and inflexibility
Term
OT Treatment of Personality Disorders
Definition
-Assistance in recognizing their symptoms
-Cognitive behavioral approaches (dialectic behavioral therapy)
Term
Delirium
Definition
A disturbance of consciousness with a decreased ability to attend
Term
Dementia
Definition
A disturbance of memory and multiple cognitive deficits
Term
Amnesic Disorder
Definition
Difficulty with memory only, but sufficient to cause functional difficulty
Term
Dementia: Stage 1
Definition
No disability
Term
Dementia: Stage 2
Definition
Complaints of forgetting normal age-related information
Term
Dementia: Stage 3
Definition
Beginning signs and deficits are noted
-Forgets important information
-Difficulty with complex tasks
Term
Dementia: Stage 4
Definition
Deficits are noted in all IADLs
-Can live at home with support
-Unable to follow and sequence written cues
-Difficulty in word finding
Term
Dementia: Stage 5
Definition
Person cannot function independently
-Poor judgement
-Difficulty with all decision making
-Forgets to take care of hygiene
Term
Dementia: Stage 6
Definition
Cannot perform ADL without cues
-Cannot sequence steps of ADL
-Cannot speak in full sentences
-Incontinence
Term
Dementia: Stage 7
Definition
Can be in a vegetative state. Bedbound and unable to respond verbally or non-verbally to questions/commands
Term
Two types of Anorexia Nervosa
Definition
1. Food restrictive type
2. Binge eating/purging type
Term
OT for Eating Disorders
Definition
1. Building trust
2. Be honest, supportive, and gently confrontational when necessary
3. Identification of the socio-economical needs that the eating disorder has fulfilled
4. Non-food related areas of interest should be pursued
Term
Oppositional Defiant Disorder
Definition
Negativistic, hostile, defiant behaviors that result in functional impairment
Term
Conduct Disorder
Definition
Disregards the rights of others leading to aggression towards people and animals, destruction of property, deceitfulness, theft, or serious violation of rules
Term
OT Treatment for Disruptive Behavior Disorders
Definition
1. Skill development may improve emotional adjustment
2. Behavioral approaches must be consistent throughout all programming
3. Educating family/teachers about the child's condition and to develop behavior management plan
Term
Autism
Definition
1. Impaired social interaction and in most cases cognitive disabilities
2.Difficulty with communication
3. Repetitive and stereotyped behaviors and movements
Term
Asperger's Disorder
Definition
1. Difficulty with social interaction
2. Restricted interests
3. Clumsiness
4. Delayed motor milestones
5. Adequate language
6. Increased social interaction and engagement in activities
Term
Rett's Syndrome
Definition
1. Deterioration of language and social skills
2. Motor deterioration (loss of purposeful hand movements)
3. Muscle tone becomes hypotonic and then spastic and then rigid
4. Irregular breathing
5. Cognitive declines
6. Seizures
Term
OT for Pervasive Developmental Disorders/ ASD
Definition
1. Develop sensorimotor, social interaction, vocational readiness, and community participation skills
2. Provide SI intervention
3.Provide adaptive and positioning equipment to facilitate functioning
4. Collaborate with the family and interdisciplinary team to promote occupational performance and social participation
Term
Reactive Attachment Disorder
Indicators of pathogenic care
Definition
1. Disregard for the child's basic emotional needs
2. Disregard for the child's basic physical needs
3. Repeated changes of the primary caregiver
Term
Reactive Attachment Disorder-Inhibited Type
Definition
1. Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions
2. Interactions are excessively inhibited
Term
Reactive Attachment Disorder- Disinhibited Type
Definition
1. Indiscriminate sociability with inability to exhibit appropriate selective attachments
2. Demonstrates excessive familiarity with relative strangers
Term
OT Treatment of Reactive Attachment Disorder
Definition
1. Close and ongoing collaboration with the child's family
2. Actively involve the parents in treatment
3. Assist children to form a secure sense of self
4. Limit child's exposure to multiple caregivers
5. High levels of structure and consistency
Term
ADHD Three Subtypes
Definition
1. Inattention
2. Hyperactive-Impulsive
3. Combined
Term
Symptoms of ADHD Inattention
Definition
-Lack of attention to detail
-Poor listening
-Limited follow through
-Difficulty with organization
-Avoidance of tasks requiring sustained attention
-Distractibility
Term
Symptoms of AHDH Hyperactivity
Definition
-Fidgeting
-Inability to remain seated
-Inappropriate activity level
-Difficulty with quiet, sedentary activities
- Frequent movement
-Excessive talking
Term
Symptoms of ADHD Impulsivity
Definition
-Difficulty waiting turns
-Interrupts
Term
OT Treatment for ADHD
Definition
-Environmental modifications and activity adaptations to structure the child's environment to enhance function
-Elimination of sensory distractions, use of lists, date books
-Training in social skills and self-management
-Intervention to promote sensory modulation
-Collaboration with IEP team
Term
ID: IQ 55-69
Definition
Mild Intellectual Disability
-Focus: Acquiring social and vocational skills
Term
ID: IQ 40-54
Definition
Moderate Intellectual Disability
-Focus: Acquiring independence in routine daily skills and skills necessary to perform in desired occupational roles
Term
ID: IQ 25-39
Definition
Severe Intellectual Disability
-Focus:Acquiring communication skills and some basic health habits
Term
ID: IQ 25 and below
Definition
Profound Intellectual Disability
-Focus: Assistance and supervision are required for basic survival
Term
OT Treatment for Intellectual Disabilities
Definition
1. Self-determination and person-centered planning within the persons capabilities
2. Development of community and social participation
Term
Evaluation Focus for OT Mental Health
Definition
1. Determine values, interests, desired occupational roles, and self-determined goals
2. ID strengths
3.ID limits
4.Determine functional problems
5. Treatment history and interest in engaging in treatment
6. ID coping skills, stressors, and environmental and social support
Term
Role of OTA in Evaluation in MH
Definition
-Can contribute to the evaluation process in collaboration with OTR, supervision required
-Cannot independently evaluate or interpret evaluation results
Term
OT Treatment in MH: Acute Hospitilization
Definition
1. Management of all behaviors that threaten safety
2. Engagement in activities that are do-able (brief and structured) to enable success, motivation, and participation
3.Engage the person in the treatment process
4. Relaxation and stress management
5. Skill development to pursue desired occupational roles
6. Engage in activities to promote communication and self-expression
Term
OT Treatment in MH: Long-term Hospitilization
Definition
1. Develop and implement a oplan for self-determined goal achievement
2.Provide normalizing environment to encourage engagement and participation
3. Provide graded activities to develop skills needed for ADL/IADL, social participation, leisure, work
4. Relaxation and Stress Management
5. Explore external supports for post-discharge
Term
OT Treatment in MH: Community
Definition
1. Services that facilitate recovery and assist in the maintenance of existing skills
2. Continued skill development
3. Develop skills to obtain concrete practical resources to support community living
4 Monitoring of the individual for changing clinical, personal, and social needs
Term
Role of OTA in Treatment in MH
Definition
1. OTA implements intervention with supervision of the OTR
- level of supervision depends on the OTA's experience and service competency
2. OTA informs the OTR of any changes in the client's status
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